• 제목/요약/키워드: Fertility Rates

검색결과 262건 처리시간 0.027초

Efficacy of embryo transfer on day 2 versus day 3 according to maternal age in patients with normal ovarian response

  • Lee, Jung-Woo;Cha, Jeong-Ho;Shin, Sun-Hee;Kim, Yun-Jeong;Lee, Seul-Ki;Park, Choon-keun;Pak, Kyung-Ah;Yoon, Ji-Sung;Park, Seo-Young
    • Clinical and Experimental Reproductive Medicine
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    • 제44권3호
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    • pp.141-145
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    • 2017
  • Objective: Delaying embryo transfer (ET) enables us to select among the embryos available for transfer and is associated with positive effects on implantation and pregnancy outcomes. However, the optimal day for ET of human cleavage-stage embryos remains controversial. Methods: A retrospective study of 3,124 in vitro fertilization/intracytoplasmic sperm injection cycles (2,440 patients) was conducted. We compared the effects of day 2 and 3 ET on rates of implantation and pregnancy outcomes between young maternal age (YMA; < 38 years old, n = 2,295) and old maternal age (OMA; ${\geq}38years\;old$, n = 829) patient groups. Results: The YMA and OMA groups did not differ in terms of patient characteristics except for the proportion of unexplained factor infertility, which was significantly greater in the OMA group, and the proportion of arrested embryos, which was significantly greater in the YMA group. However, the biochemical pregnancy, clinical pregnancy, ongoing pregnancy, abortion, and implantation rates per cycle were not significantly different between day 2 and 3 ET in the YMA group or the OMA group. Conclusion: We suggest that offering patients the opportunity to decide which day would be suitable for ET could be part of a patient-friendly protocol that takes into consideration an infertile woman's circumstances and work schedule by allowing ET to be performed on day 2 instead of the traditional transfer on day 3.

The role of gonadotropin-releasing hormone agonists in female fertility preservation

  • Lee, Jae Hoon;Choi, Young Sik
    • Clinical and Experimental Reproductive Medicine
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    • 제48권1호
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    • pp.11-26
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    • 2021
  • Advances in anticancer treatments have resulted in increasing survival rates among cancer patients. Accordingly, the quality of life after treatment, particularly the preservation of fertility, has gradually emerged as an essential consideration. Cryopreservation of embryos or unfertilized oocytes has been considered as the standard method of fertility preservation among young women facing gonadotoxic chemotherapy. Other methods, including ovarian suppression and ovarian tissue cryopreservation, have been considered experimental. Recent large-scale randomized controlled trials have demonstrated that temporary ovarian suppression using gonadotropin-releasing hormone agonists (GnRHa) during chemotherapy is beneficial for preventing chemotherapy-induced premature ovarian insufficiency in breast cancer patients. It should also be emphasized that GnRHa use during chemotherapy does not replace established fertility preservation methods. All young women facing gonadotoxic chemotherapy should be counseled about and offered various options for fertility preservation, including both GnRHa use and cryopreservation of embryos, oocytes, and/or ovarian tissue.

Retrospective study of single vitrified-warmed blastocyst transfer cycles according to the presence of morphokinetic variables

  • Hur, Yong Soo;Ryu, Eun Kyung;Hyun, Chang Seop;Yang, Seong Ho;Yoon, San Hyun;Lim, Kyung Sil;Lee, Won Don;Lim, Jin Ho
    • Clinical and Experimental Reproductive Medicine
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    • 제45권1호
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    • pp.52-55
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    • 2018
  • This study retrospectively assessed whether time-lapse data relating to developmental timing and morphology were associated with clinical outcomes, with the eventual goal of using morphokinetic variables to select embryos prospectively for cryopreservation. In this study, we examined the clinical outcomes of single vitrified-warmed blastocyst transfer cycles that were cultured in a time-lapse incubation system. The morphokinetic variables included uneven pronuclei, an uneven blastomere, multinucleation, and direct, rapid, and irregular division. A total of 164 single vitrified-warmed blastocyst transfer cycles were analyzed (102 cycles of regularly developed blastocysts and 62 cycles of blastocysts with morphokinetic variables). No significant differences in the age of females or the standard blastocyst morphology were found between these two groups. The regularly developed blastocysts showed significantly higher implantation and clinical pregnancy rates than the blastocysts exhibiting morphokinetic variables (30.4% vs. 9.7% and 37.3% vs. 14.5%, respectively; p< 0.01). The blastocysts that exhibited morphokinetic variables showed different mean development times compared with the regularly developed blastocysts. Although morphokinetic variables are known to have fatal impacts on embryonic development, a considerable number of embryos developed to the blastocyst stage. Morphokinetic variables had negative effects on the implantation and clinical pregnancy rates in vitrified-warmed blastocyst transfer cycles. These findings suggest that blastocysts cultured in a time-lapse incubation system should be considered for selective cryopreservation according to morphokinetic variables.

Effect of artificial shrinkage on clinical outcome in fresh blastocyst transfer cycles

  • Hur, Yong-Soo;Park, Jeong-Hyun;Ryu, Eun-Kyung;Yoon, Hae-Jin;Yoon, San-Hyun;Hur, Chang-Young;Lee, Won-Don;Lim, Jin-Ho
    • Clinical and Experimental Reproductive Medicine
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    • 제38권2호
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    • pp.87-92
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    • 2011
  • Objective: This study aimed to determine the safety and clinical effect of artificial shrinkage (AS) in terms of assisted hatching of fresh blastocysts. Also, we evaluated the correlation between patient age and the effect of AS on clinical outcome. Methods: Two AS methods, using a 29-gauge needle and laser pulse, were compared. Seventy-three blastocysts were shrunk using a 29-gauge needle and the same number of other blastocysts were shrunk by a laser pulse. We evaluated the shrunken blastocysts hourly and considered them viable if they re-expanded >70%. Blastocyst transfer cycles (n=134) were divided into two groups: a control group consisted of the cycles whose intact embryos were transferred (n=100), while the AS group consisted of the cycles whose embryos were replaced following AS (n=34). The implantation and pregnancy rates of the control group and AS group were compared ($p$ <0.05). Results: The re-expansion rates of the 29-gauge needle and laser pulse AS groups were similar (56 [76.7%] vs. 62 [84.9%], respectively). All of the remaining shrunken blastocysts were re-expanded within 2 hours. There was no degeneration of shrunken blastocysts. The total and clinical pregnancy rate of the AS group (23 [67.6%]; 20 [58.8%], respectively) was significantly higher than that of the control group (47 [47.0%]; 39 [39.0%], respectively). In the older patient group, there was no difference in the clinical outcomes between the AS and control groups. Conclusion: These results suggest that AS of blastocoele cavity, followed by the transfer, would be a useful approach to improve the clinical outcome in cycles in which fresh blastocyst stage embryos are transferred.

최근의 피임실천수준과 출산력추이에 관한 고찰 -몇가지 정책적 제언을 중심으로- (A Review of Relationship Between Level of Fertility and Contraceptive Prevalence in Korea: Some Implication for Policy Suggestion)

  • 고갑석
    • 한국인구학
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    • 제8권2호
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    • pp.79-92
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    • 1985
  • Fertility has been declined since 1966 (see Table 1). This fertility reduction was duely caused by age at first marriage, induced abortion and contraceptive practice which has been largely increased in recent years. Although tbe proximate determinant such as induced abortion, age at marriage and breastfeeding can and do have an effect on fertility, the principal cause of the reduction in fertility in Korea during the fertility transition can be supported by correlation between level of fertility and contraceptive prevalence (See Fig. 4). Taking a regression equation between fertility (TER. Y) and prevalence level (X), the total fertility rate in 1984 was estimated as 1.9 and 2.1 based on lenear and expotential function shown as follow; $Y_1$=5.709-0.0549 X and $Y_2$_______80________ 1+e2.433+0.017X ($R^2$=O. 93) ($R^2$=0. 96) Where $Y_1$ and $Y_2$ denote total fertility rates obtained through two equations respectivelly. The peak of contraceptive prevalence was assumdd as 80 percent which is almost upper limit in human society. On the other hand, an observed value of 1984 fertility level obtained from five month period shows 2.1 which is coincident with logistic fitting after the adjustment of response error assumed around 10 to 20 percent, At any rate, fertility of Korean women will have been reached replacement level (2.1) by 1985.Thus policy for family planning program must be reviewed toward the direction of integrated approach particularly with MCH program inasmuch as fertility in Korea has already shown population replacement level that require more good quality of service in family planning and their There must be an advanced level of fertility in Korea because wide use of contraception and induced life abortion and age at marriage will effect modern fertility which shows up and down trend between 2.1 and 1.5 in general.

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Long Cut Straw Provides Stable the Rates of Survival, Pregnancy and Live Birth for Vitrification of Human Blasotcysts

  • Lee, Jung-Woo;Cha, Jeong-Ho;Shin, Sun-Hee;Kim, Yun-Jeong;Lee, Seul-Ki;Cha, Hye-Jin;Kim, Ji-Hae;Ahn, Ji-Hyun;Kim, Hye-Young;Pak, Kyung-Ah;Yoon, Ji-Sung;Park, Seo-Young;Park, Choon-keun
    • 한국발생생물학회지:발생과생식
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    • 제20권3호
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    • pp.219-225
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    • 2016
  • Most of the commercial devices for vitrification are directly immersed into the warming solution (WS) for increasing of warming rate. However, the previous modified cut standard straw (MCS) which has reported is difficult to immerse into the WS. The aim of this study was to investigate whether the long cut straw (LCS) could be useful as a stable tool for vitrified-warmed human blastocysts. A total of 138 vitrified-warmed cycles were performed between November 2013 and November 2014 (exclusion criteria: women ${\geq}38$ years old, poor responder, surgical retrieval sperm, and severe male factor). The artificial shrinkage was conducted using 29-gauge needles. Ethylene glycol and dimethyl sulfoxide (7.5% and 15% (v/v)) were used as cryoprotectants. Freezing and warming were conducted using the LCS tool. The cap of LCS was removed using the forceps in the liquid nitrogen ($LN_2$) and then directly immersed into the first WS for 1 min at $37^{\circ}C$ (1 M sucrose). Only re-expanded blastocysts were transferred after it was cultured in sequential media for 18-20 h. A total of 294 blastocysts were warmed, and all were recovered (100%). Two hundred eighty-five embryos were survived (96.9%). The vitrified-warmed blastocysts of all patients were transferred without any cancellation. We were able to achieve a reasonable implantation (24.2%), following by clinical pregnancy (36.2%), which then continued to ongoing pregnancy (36.2%), and live birth (31.2%). Using LCS is achieved the acceptable rates of survival, pregnancy and live birth. Therefore, the LCS could be considered as a stable and simple tool for human embryo vitrificaton.

조선후기의 출산력, 사망력 및 인구증가: 네 족보에 나타난 1700$\sim$1899년간 생몰 기록을 이용한 연구 (Fertility, Mortality, and Population Growth in 18th and 19th Century Korea: Evidence from Genealogies)

  • 차명수
    • 한국인구학
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    • 제32권1호
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    • pp.113-137
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    • 2009
  • 이 논문의 목적은 족보에 나타난 생몰 기록을 근거로 조선후기의 사망력, 출산력, 인구 증가율을 추정하는 것이다. 족보에서 파악되 양반 남성의 사망력 수준을 식민지기 사망력 추계 및 모델 생명표를 이용해 전체 인구의 사망력으로 변환한 결과 18, 19세기 우리나라 남성의 출생시 기대여명은 23세로 추정되었다. 족보에서 계산된 양반 여성의 출산력 수준으로부터 여성 초혼 연령 및 식민지기 출산력 추계를 이용해서 전체 인구의 출산력을 추정한 결과는 조선 후기의 합계 출산율이 6.81이었음을 알려주었다. 추정된 조선 후기 사망력 및 출산력 지표를 안정 인구를 묘사하는 방정식에 대입해서 추정한 18, 19세기의 인구 증가율은 0.62%였다.

정체 수역 내에서 미세조류의 생리생화학적 분석에 의한 수화발생 잠재력 탐색 (Probe of Algal Growth Potential (AGP) by Physio-Biochemical Analysis of Microalgae in the Stagnant Watershed)

  • 김미경;신재기;지홍기
    • ALGAE
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    • 제20권2호
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    • pp.127-132
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    • 2005
  • Algal growth potentials were probed by algal growth rates, maximal PSII quantum yields and ATP amount as well as dry weights of algae to evaluate the water fertility due to the algal growth in the stream (CT) and stagnant watershed (WW). Oscillatoria agardhii (CY) and Coelastrum reticulatum (CH) were cultured in nitrogen (N) and phosphorus (P) starvation media (CH-10 medium) and re-inoculated in CT and WW for 7 days. Cell division rates of CY were the highest (k = 7.5) in WW after N starvation, while those of CH were the hight (k = 2.97) in WW after P starvation. The growth of CY was limited by P, while that of CH was by N. Conversely, maximal PSII quantum yields of CH were generally higher than those of CY in CT and WW according to culture time. CY was much more sensibly adapted than CH according to the variations of nutrient amounts in WW. The water fertility was much higher in WW than in CT. The potential assessment tool for water fertility will be able to compensate for the limit of physio-chemical analyses and to be applied as a monitoring system to forecast red-tide.

Effects of various combinations of cryoprotectants and cooling speed on the survival and further development of mouse oocytes after vitrification

  • Cha, Soo-Kyung;Kim, Bo-Yeun;Kim, Mi-Kyung;Kim, You-Shin;Lee, Woo-Sik;Yoon, Tae-Ki;Lee, Dong-Ryul
    • Clinical and Experimental Reproductive Medicine
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    • 제38권1호
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    • pp.24-30
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    • 2011
  • Objective: The objectives of this study were to analyze efficacy of immature and mature mouse oocytes after vitrification and warming by applying various combinations of cryoprotectants (CPAs) and/or super-rapid cooling using slush nitrogen ($SN_2$). Methods: Four-week old ICR female mice were superovulated for GV- and MII-stage oocytes. Experimental groups were divided into two groups. Ethylene glycol (EG) only group: pre-equilibrated with 1.5 M EG for 2.5 minutes and then equilibrated with 5.5 M EG and 1.0 M sucrose for 20 seconds. EG+dimethylsulfoxide (DMSO) group: pre-equilibrated with 1.3 M EG+1.1 M DMSO for 2.5 minutes and equilibrated with 2.7 M EG+2.1 M DMSO+0.5 M sucrose for 20 seconds. The oocytes were loaded onto grids and plunged into $SN_2$or liquid nitrogen ($LN_2$). Stored oocytes were warmed by a five-step method, and then their survival, maturation, cleavage, and developmental rates were observed. Results: The EG only and EG+DMSO groups showed no significant difference in survival of immature oocytes vitrified after warming. However, maturation and cleavage rates after conventional insemination were greater in the EG only group than in the EG+DMSO group. In mature oocytes, survival, cleavage, and blastocyst formation rates after warming showed no significant difference when EG only or EG+DMSO was applied. Furthermore, cleavage and blastocyst formation rates of MII oocytes vitrified using $SN_2$ were increased in both the EG only and EG+DMSO groups. Conclusion: A combination of CPAs in oocyte cryopreservation could be formulated according to the oocyte stage. In addition, $SN_2$ may improve the efficiency of vitrification by reducing cryoinjury.

최근의 가족계획실태와 전망 (Recent Clanges in Contraceptive Use in Korea)

  • 조남훈;이임전
    • 한국인구학
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    • 제8권1호
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    • pp.118-138
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    • 1985
  • This paper is aimed to analyse the recent changes in family planning as a step in an evaluation of the results of the population control policy which has been strenuously pursued by the government since December 1981. The data used in this analysis comes from the 1985 national fertility and family planning survey conducted by the Korea Institute for Population and Health (KIPH) in May 1985. According to the 1985 survey data, there have been great changes in both the contraceptive practice and fertility rates since the strengthening of the government's population control policy in 1 981. The contraceptive practice rate for married women aged 15-44 has increased from 57.7% in 1982 to 70.3% in 1985, an increase of 12.6% points in the short span of only 3 years. During the same period, the total fertility rate has declined from 2.7 in 1982 to the population replacement level which was planned to achieve by 1 988. More than 80% of women aged over 30 or with two children or more are practicing contraception, while the practice rates of women with 0-1 children are 14.0% and 45.1% respectively. The survey has revealed that the increase of contraceptive practice rate during 1982-1985 has mainly attributed to the high acceptance of sterilization procedures which practice rate of the married women has increased from 28.1% to 40.3% for the period. Also, the survey data shows that 24.7% of those women with only one child is practicing contraception for thepurpose of fertility termination. The government, taking into account of rapid changes in contraceptive practice and fertility rates, is formulating a population plan during the sixth fiveyear economic and social development plan (1987-1991) to achieve 1% ofpopulation growth rate by 1993, which was planned to realize by 2000. In order to meet this demographic goal, the existing population control policy measures should be improved to be suited to the recent contraceptive use and fertility changes. From this standpoint, the following considerations should be put forth; 1) improvement of the current program management systems including target allocation and evaluation schems for recruiting new acceptors in the young 20s groups to use contraceptives for birth spacing and to increase high continuation rates through the strengthening of follow-up services for the acceptors, 2) increase of self-supporting contraceptive users by promoting commercial advertisements on contraceptives through mass media including T.V. and radio, 3) development of social support policies including incentive schems, and strengthening of IE & C activities for increasing the proportion of the one-child family, 4) strengthening of population and family planning education in and out school youth, and 5) strengthening of management capabilities at the provincial and local program managers.

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